Health Promotion Journal of Australia Health Promotion Journal of Australia Society
Journal of the Australian Health Promotion Association
RESEARCH ARTICLE

Using rapid assessment and response to operationalise physical activity strategic health communication campaigns in Tonga

Tahir Turk A E , Netina Latu B , Elizabeth Cocker-Palu C , Villiami Liavaa B , Paul Vivili C , Sara Gloede D and Allison Simons D

A Communication Partners International, 24 Dulwich Road, Springfield, NSW 2250, Australia.

B Ministry of Training, Employment, Youth and Sport (MOTEYS), PO Box 2395, Taufa’aahau Road, Nuku’alofa, Tonga.

C Ministry of Health, Health Promotion Unit, PO Box 59, Taufa’aahau Road, Nuku’alofa, Tonga.

D Australian Sports Commission, International Sport for Development, Canberra, ACT 2600, Australia.

E Corresponding author. Email: tturk@bigpond.com

Health Promotion Journal of Australia 24(1) 13-19 http://dx.doi.org/10.1071/HE12903
Submitted: 6 December 2011  Accepted: 27 October 2012   Published: 21 March 2013

Abstract

Issues addressed: The aim of the present study was to identify stakeholder and program beneficiary needs and wants in relation to a netball communication strategy in Tonga. In addition, the study aimed to more clearly identify audience segments for targeting of communication campaigns and to identify any barriers or benefits to engaging in the physical activity program.

Methods: A rapid assessment and response (RAR) methodology was used. The elicitation research encompassed qualitative fieldwork approaches, including semistructured interviews with key informants and focus group discussions with program beneficiaries. Desk research of secondary data sources supported in-field findings.

Results: A number of potential barriers to behavioural compliance existed, including cultural factors, gender discrimination, socioeconomic factors, stigmatising attitudes, the threat of domestic violence, infrastructure and training issues. Factors contributing to participation in physical activity included the fun and social aspects of the sport, incentives (including career opportunities, highlighting the health benefits of the activity and the provision of religious and cultural sanctions by local leaders towards the increased physical activity of women.

Conclusions: The consultative approach of RAR provided a more in-depth understanding of the need for greater levels of physical activity and opportunities for engagement by all stakeholders. The approach facilitated opportunities for the proposed health behaviours to be realised through the communication strategy. Essential insights for the strategy design were identified from key informants, as well as ensuring future engagement of these stakeholders into the strategy.

So what?: The expanded use of RAR to inform the design of social marketing interventions is a practical approach to data collection for non-communicable diseases and other health issues in developing countries. The approach allows for the rapid mobilisation of scarce resources for the implementation of more strategic, targeted communication campaigns to support behavioural changes.

Key words: physical activity, formative evaluation, health behaviours, chronic disease.


References

[1]  Hodge A, Dowse GK, Zimmet P (1996) Obesity in Pacific populations. Pac Health Dialog 1, 77–86.

[2]  Government of Tonga. Hala Fononga: path to good health. Nuku’alofa, Tonga: Tonga National Strategy to Prevent and Control Non-Communicable Diseases; 2010.

[3]  Taylor R, Bampton D, Lopez AD (2005) Contemporary patterns of Pacific Island mortality. Int J Epidemiol 34, 207–14.
Contemporary patterns of Pacific Island mortality.CrossRef | 15465904PubMed | open url image1

[4]  Government of Tonga. Ministry of Health annual report. Nuku’alofa, Tonga: Ministry of Health; 2010.

[5]  World Health Organization (WHO). Tonga commitment to promote healthy lifestyles and supportive environment. Meeting of Ministers of Health for the Pacific Island Countries. Nuku’alofa, Tonga. Geneva: WHO; 2003.

[6]  World Health Organization. Joint WHO/FAO Expert Consultation on diet, nutrition and the prevention of chronic diseases. Geneva: WHO; 2002.

[7]  Duarte NLCS, Colagiuri S, Palu T, Wang XL, Wilcken DE (2003) Obesity, Type II diabetes and the beta 2 adrenoceptor gene Gin27GLu polymorphism in the Tongan population. Clin Sci 104, 211–15.
Obesity, Type II diabetes and the beta 2 adrenoceptor gene Gin27GLu polymorphism in the Tongan population.CrossRef | 1:CAS:528:DC%2BD3sXhsFajt7w%3D&md5=014bc01a4dc03c0d7558c39db3265594CAS | open url image1

[8]  Smith BJ, Phongsavan P, Havea D, Halavatau V, Chey T (2007) Body mass index, physical activity and dietary behaviours among adolescents in the Kingdom of Tonga. Public Health Nutr 10, 137–44.
Body mass index, physical activity and dietary behaviours among adolescents in the Kingdom of Tonga.CrossRef | 1:STN:280:DC%2BD2s%2FlslaqtQ%3D%3D&md5=4803b3ff667192b1ed5578ffec555124CAS | 17261222PubMed | open url image1

[9]  Coyne T. Lifestyle diseases in Pacific communities. Noumea: Secretariat of the Pacific Community; 2000.

[10]  World Health Organization–Western Pacific Regional Office (WPRO). Building healthy communities and populations. Manilla: WPRO. Available from: http://www.wpro.who.int/about/administration_structure/dhp/about_us/en/index.html [Verified 28 September 2011].

[11]  Women Win. International guide to designing sport programmes for girls. Recommendations from the field. 2010; Available from: http://www.sportanddev.org/toolkit/manuals_and_tools/?2512/International-Guide-to-Designing-Sport-Programmes-for-Girls [Verified 25 September 2011].

[12]  Morris A. Nine a side basketball in the kingdom of Tonga: a case study in negotiating gender roles. In: Clark CD, editor. Transactions at play, play and culture studies, Vol. 9. Lanham, MD: University Press of America; 2009.

[13]  McCabe MP, Fotu K, Mavoa H, Faeamani K (2011) Socio-cultural agents and their impact on body image and body change strategies among adolescents in Fiji, Tonga, Tongans in New Zealand and Australia. Obes Rev. 12, 61–7.
Socio-cultural agents and their impact on body image and body change strategies among adolescents in Fiji, Tonga, Tongans in New Zealand and Australia.CrossRef | 22008560PubMed | open url image1

[14]  World Health Organization–Western Pacific Regional Office (WPRO). Strategic health communication (joint WHO/SPC/UNFPA/UNICEF initiative merging COMBI and BCC approaches in health communication). Presentation at Tonga National Centre by Dr Temo Waqanivalu to Tonga Ministry of Health stakeholders workshop, Nuku’Alofa, 16–20 August 2010. Nadi: World Health Organization; 2010.

[15]  Scrimshaw NS, Gleason GR. Rapid assessment procedures–qualitative methodologies for planning and evaluation of health related programmes. International Nutrition Foundation for Developing Countries (INFDC). Boston: USA Library of Congress; 1992.

[16]  O’Sullivan GA, Yonkler JA, Morgan W, Merrit AP. A field guide to designing a health communication strategy. Baltimore: Johns Hopkins Bloomberg School of Public Health/Centre for Communication Programs; 2003.

[17]  Commonwealth Health Ministers Update. Progress towards achieving the health MDGs in the Pacific Islands: highlights, initiatives and challenges. Suvu, Fiji: Public Health and Social Resources Divisions of the Secretariat of the Pacific Community; 2010.

[18]  Aggleton P, Malcolm A. Rapid assessment and response: adaptation guide for work with especially vulnerable young people. Geneva: WHO; 2004.

[19]  Kamineni VV, Turk T, Wilson N, Satyanarayana S, Chauhan LS (2011) A rapid assessment and response approach to review and enhance advocacy, communication and social mobilisation for tuberculosis control in Odisha state, India. BMC Public Health 11, 463
A rapid assessment and response approach to review and enhance advocacy, communication and social mobilisation for tuberculosis control in Odisha state, India.CrossRef | 21663623PubMed | open url image1

[20]  Kreuger RA. Focus groups: a practical guide for applied research. London: Sage Publications; 2009.

[21]  Mezulis AH, Abramson LY, Hyde JS, Hankin BL (2004) Is there a universal positivity bias in attributions? A meta-analytic review of individual, developmental, and cultural differences in the self-serving attributional bias. Psychol Bull 130, 711–47.
Is there a universal positivity bias in attributions? A meta-analytic review of individual, developmental, and cultural differences in the self-serving attributional bias.CrossRef | 15367078PubMed | open url image1

[22]  Behling O, Law KS. Translating questionnaires and other research instruments: problems and solutions. Thousand Oaks, CA: Sage Publications; 2000.

[23]  Sperber D. Metarepresentations in an evolutionary perspective. In Sperber D, editor. Metarepresentations: a multidisciplinary perspective (pp. 117–137). Oxford: Oxford University Press; 2000.

[24]  Eisenhardt KM, Graebner ME (2007) Theory building from cases: opportunities and challenges. Acad Manage J 50, 25–32.

[25]  Strauss A, Corbin J. Basics of qualitative research. Thousand Oaks, CA: Sage Publications; 1998.

[26]  Schreiber RS. The ‘how to’ of grounded theory: avoiding the pitfalls. In Schreiber RS, Stern PN, editors. Using grounded theory in nursing (pp. 191–209). New York: Springer; 2001.

[27]  Ajzen I (2002) Perceived behavioural control, self-efficacy, locus of control and the theory of planned behaviour. J Exp Soc Psychol 5, 453–74.

[28]  Spiggle S (1994) Analysis and interpretation of qualitative data in consumer research. J Consum Res 21, 491–503.
Analysis and interpretation of qualitative data in consumer research.CrossRef | open url image1

[29]  World Health Assembly. Global strategy on diet, physical activity and health. Geneva: World Health Organization. 2004. Available from: http://www.who.int/dietphysicalactivity/strategy/eb11344/strategy_english_web.pdf [Verified 30 September 2011].

[30]  Ajzen I (1991) The theory of planned behavior. Organ Behav Hum Decis Process 50, 179–211.
The theory of planned behavior.CrossRef | open url image1

[31]  Hagströmer M. Assessment of health-enhancing physical activity at population level. Stockholm: Karolinska Insitute; 2007.

[32]  Young LH (2002) Producing what in the transition? Health messaging and cultural constructions of health in Tonga. Pac Health Dialog 2, 296–302.



Export Citation